We hypothesized that children with attention-deficit/hyperactivity disorder (ADHD) would underperform on neuropsychological tests that are sensitive to executive function impairments. We further proposed that a linear discriminant analysis using behavioral and neuropsychological variables as dependent variables would pinpoint the capability of behavioral questionnaires and neuropsychological tests to predict the correct classification of ADHD and control children. We designed a transversal study with 62 seven-to twelve-year-old children with ADHD and 62 Full Scale IQ-matched controls using two behavioral scales and 13 neuropsychological tests. Using analysis of variance and covariance with age and school achievement and multifactor analysis of variance, we found that behavioral variables established robust, statistically significant differences between groups (p < .001). Children with ADHD scored worse than controls on 31 out of 61 neuropsychological variables. Children with ADHD, however, obtained better scores that were statistically significant on WISC-R Comprehension and Picture completion. A linear discriminant analysis with nine behavioral variables correctly classified 100% of the participants in both groups. Another linear discriminant analysis using 10 neuropsychological variables correctly classified 85.48% of the participants in both groups. We propose a core battery of selected tests for assessing children with ADHD. The significance of cross-cultural analyses of different developmental disturbances is emphasized.
Get full access to this article
View all access options for this article.
References
1.
Achenbach, T.M. (1986). Manual for the Child Behavior Checklist-Direct Observation form. Burlington: University of Vermont.
2.
American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author .
3.
American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders-Revised (3rd ed.). Washington, DC: Author.
4.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
5.
Anastasi, A. (1988). Psychological testing. New York: Macmillan.
6.
Ardila, A. (1995). Directions of research in cross-cultural neuropsychology . Journal of Clinical and Experimental Neuropsychology, 17, 143-150.
7.
Ardila, A., & Rosselli, M. (1992). Neuropsicologia clinica [Clinical neuropsychology] . Medellin, Colombia: Prensa Creativa .
8.
Ardila, A., & Rosselli, M. (1994). Development of language, memory and visuospatial abilities in five- to 12-year-old children using a neuropsychological test battery. Developmental Neuropsychology, 10, 97-120.
9.
Ardila, A., & Rosselli, M. (1996). Soft neurological signs in children: A normative study. Developmental Neuropsychology, 12, 179-198.
10.
Ardila, A., & Rosselli, M. (in press-a). Educational effects on the Rey-Osterrieth Complex Figure . In J. Knight & E. Kaplan (Eds.), Handbook of Rey-Osterrieth Complex Figure usage: Clinical and research applications.
11.
Ardila, A., & Rosselli, M. (in press-b). Socio-economic status and normative data for soft signs . Developmental Neuropsychology.
12.
Ardila, A., Rosselli, M., & Puente, A.E. (1994). Neuropsychological evaluation of the Spanish speaker . New York: Plenum Press.
13.
Aronowitz, B., Liebowitz, M., Hollander, E., Fazzini, E., Durlach-Misteli, C., Frekel, M., Mosovich, S., Garfinkel, R., Saoud, J., & Delbene, D. (1994). Neuropsychiatric and neuropsychological findings in conduct disorder and attention deficit hyperactivity disorder. Journal of Neuropsychiatry and ClinicNeurosciences, 6, 245-249.
14.
Barkley, R.A. (1988). Attention. In E. M. Tramontana & S. Hooper (Eds.), Assessment issues in child clinical neuropsychology (pp. 145-176). New York: Plenum Press.
15.
Barkley, R.A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.
16.
Barkley, R.A. (1991). Attention deficit hyperactivity disorder: A clinical workbook. New York: Guilford Press .
17.
Barkley, R.A., DuPaul, G.J., & McMurray, M.B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology , 58, 775-789.
18.
Barkley, R.A., Grodzinsky, G., & DuPaul, G.J. (1992). Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report. Journal of Abnormal Child Psychology, 20, 163-188.
19.
Benton, A.L. (1986) Reaction time in brain disease: Some reflections . Cortex, 22, 141-150.
20.
Bernatzik, H.A. (1957). Razas y pueblos del mundo [World races and people], Vols. 1-3. Barcelona, Spanin: Ediciones Ave.
21.
Beuterman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct depressive anxiety and other disorders. American Journal of Psychiatry,148, 564-577.
22.
Boucugnani, L.L., & Jones, R.W. (1989). Behaviors analogous to frontal lobe dysfunction in children with attention deficit disorder. Archives ofClinical Neuropsychology, 4, 161-173.
23.
Cantwell, D.P., & Baker, L. (1991). Association between attention deficit hyperactivity disorder and learning disorders. In S. E. Shaywitz & B. A. Shaywitz (Eds.), Attention deficit disorder comes of age: Toward the twenty-first century (pp. 145-164). Austin, TX: PRO-ED .
Denckla, M.B. (1989). Executive function, the overlap zone between attention deficit hyperactivity disorder and learning disabilities. InternationalPediatrics, 4, 115-160.
30.
Denckla, M.B. (1996). Research on executive function in a neurodevelopmental context: Application of clinical measures. Developmental Neuropsychology , 12, 5-15.
31.
De Renzi, E., & Faglioni, P. (1978). Normative data and screening power of a shortened version of the token test. Cortex, 14, 327-342.
32.
DuPaul, G.J. (1995). Parent and teacher ratings of ADHD symptoms: Psychometric properties in a community-based sample. Journal of Clinical Child Psychology, 20, 245-253.
33.
DuPaul, G.J., Rapport, M., & Perrielo, L.M. (1990). Teacher ratings of academic performance: The development of an academic performance rating scale. Unpublished manuscript, University of Massachusetts Medical Center , Worcester.
34.
Eyestone, L.L., & Howell, R.J. (1994). An epidemiological study of attention deficit hyperactivity disorder and major depression in a male prison population. Bulletin of the American Academy of Psychiatric Law, 22, 181-193.
35.
Fisher, M., Barkley, R.A., Edelbrock, C.S., & Smallish, L. (1990). The adolescent outcomes of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. Journal of Consulting and Clinical Psychology, 58, 580-588.
36.
Fletcher, J.M., Morris, R.D., & Francis, D.J. (1992). Methodological issues in the classification of attention-related disorders. In S. E. Shaywitz & B. A. Shaywitz (Eds.), Attention deficit disorder comes of age: Toward the twenty-first century (pp. 13-27). Austin, TX: PRO-ED.
37.
Glow, R.A. (1981). Cross-validity and normative data on the Conners Parent and Teacher Rating Scale. In K. D. Gadow & J. Loney (Eds), Psychology aspects of drug treatment for hyperactivity. Boulder, CO: Westview Press.
38.
Glow, R.A., Glow, P.H., & Rump, E.E. (1982). The stability of child behavior disorders: A one year test-retest study of Adelaide versions of the Conners Teacher and Parent Rating Scales. Journal of Abnormal Child Psychology, 16, 527-537.
39.
Goodglass, H., & Kaplan, E. (1983). The assessment of aphasis and related disorders (2nd ed.). Philadelphia: Lea & Febiger.
40.
Gorestein, E., Mammato, C., & Sandy, E. (1989). Performance of inattentive-overactive children on selected measures of prefrontal type function. Journal of Clinical Psychology, 45, 619-632.
41.
Goyette, C.H., Conners, C.K., & Ulrich, R.F. (1978). Normative data on the revised Conners Parent and Teacher Rating Scale. Journal of Abnormal Child Psychology , 6, 221-236.
42.
Grodzinsky, G.M., & Diamond, R. (1992). Frontal lobe functioning in boys with attention-deficit /hyperactivity disorder. Developmental Neuropsychology, 8, 427-445.
Hynd, G.W., Alison, R.L., Semrud-Clikeman, M., Nieves N., Huettner, M.I., & Lahey B.B. (1991). Attention deficit disorder without hyperactivity: A distinct behavioral and neurocognitive syndrome. Journal ofChild Neurology, 6, S37-S43.
45.
Hynd, G.W., Morgan, A.E., Edmonds, J.E., Black, K., Riccio, C.A., & Lombardino, L. (1995). Reading disabilities, comorbid psychopathology, and specificity of neurolinguistic deficits. Developmental Neuropsychology, 11, 311-322.
46.
Kanbayashi, Y., Nakata, Y., Fujii, K., & Wada, K. (1994). Attention deficit hyperactivity disorder-related behavior among non-referred children: Parent rating of DSM-III-R symptoms. Child PsychiatricHuman Development, 25, 13-29.
47.
Kirby, E.A., & Grimley, L.K. (1992). Trastorno por deficit de atencion [Understanding and treating attention deficit disorder]. (C. M. Ardisson-Perez, Trans.). Mexico City: Limusa Editores.
48.
Lahey, B.B., Applegate, B., McBurnett, K., Biederman, J., Greenhill, L., Hynd, G.W., Barkley, R.A., Newcorn, J., Jensen, P., Richters, J., Garfinkel, B., Kerdyk, L., Frick, P.J., Ollendick, T., Perez, D., Hart, E.L., Waldman, I., & Shaffer, D. (1994). DSM-IV field trial for attention-deficit/ hyperactivity disorder in children and adolescents. American Journal of Psychiatry,151, 1673-1685.
49.
Lamminmäki, T., Ahonen, T., Närhi, V., Lyytinen, H., Todd de Barra, H. (1995). Attention deficit hyperactivity disorder subtypes: Are there differences in academic problems ?Developmental Neuropsychology, 11, 297-310.
50.
Lecours, A.R., Mehler, J., Parente, M.A., Beltrami, M.C., Canossa de Tolipan, L., Castro M. J., Carrono, V., Chagastelles, L., Dehaut, F., Delgado, R., Evangelista, A., Fajgenbaum, S., Fontoura, C., de Fraga-Karmann, D., Gurd, J., Hierro-Tome, C., Jakubovicz, R., Kac, R., Lefevre, B., Lima, C., Maciel, J., Mansur, L., Martinez, R., Nobrega, M.C., Osorio, Z., Paciornik, J., Papaterra, F., Jourdan-Penedo, M.A., Saboya, B., Scheuer, C., Batista da Silva, A., Spinardi, M., & Texeira, M. (1988). Illiteracy and brain damage 3: A contribution to the study of speech and language disorders in illiterates with unilateral brain damage (initial testing). Neuropsychologia, 26, 575-589.
51.
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
52.
Martindale, C. (1981). Cognition and Consciousness. Homewood, IL: Dorsey Press.
53.
Matier, K., Wolf, L.E., & Halperin, J.M. (1994). The psychometric properties and clinical utility of a cancellation test in children. Developmental Neuropsychology, 10, 165-177.
54.
Mattinson, R.E., Cantwell, D.P., & Baker, L. (1980). Dimensions of behavior in children with speech and language disorders. Journal of Abnormal Child Psychology , 8, 323-338.
55.
Matute, E. (1988). El aprendizaje de la lectoescritura y la especialización hemisférica para el lenguaje [Reading and writing learning, and hemispheric specialization for language]. In A. Ardila & F. Ostrosky-Solis (Eds.), Lenguaje oral y escrito [Oral and written language] (pp. 310-358). Mexico: Editorial Trillas.
56.
Milner, A.D. (1986). Chronometric analysis in neuropsychology. Neuropsychologia, 24, 115-128.
57.
Mirsky, A.F., Anthony, B.J., Duncan, C.C., Aheran, M.B., & Kellan, S.G. (1991). Analysis of the elements of attention: A neuropsychological approach. Neuropsychology Review, 2, 109-145.
58.
O'Connor, M., Foch, T., Sherry, T., & Plomin, R. (1980). A twin study of specific behavioral problems of socialization as viewed by parents. Journal of Abnormal Child Psychology, 8, 189-199.
59.
Pelham, W.E., Bender, M.E., Caddell, J., Booth, S., & Moorer, S.H. (1985). Methylphenidate and children with attention deficit disorder. Archives of General Psychiatry,42, 948-952.
60.
Pelham, W.E., Milich, R., Murphy, D., & Murphy, H.A. (1989). Normative data on the IOWA-Conners Teacher Rating Scale. Journal of Clinical Child Psychology, 18, 259-262.
61.
Pellock, J.M. (1996). Pharmacological treatment of children with attention deficit hyperactivity disorder syndrome: When to start and to stop. InternationalPediatrics, 11, 295-303.
62.
Pineda, D. (1996). Disfunción ejecutiva en niños con trastornos por deficiencia atencional con hiperactividad (TDAH). [Executive dysfunction in children with attention-deficit /hyperactivity disorder (ADHD)]. Acta Neurologica Colombiana, 12, 19-25.
63.
Pineda, D.,& Ardila, A., (1991). Neuropsicología: Evaluación Clinica y Psicometria [Neuropsychology: Clinical and psychometric assessment]. Medellín, Colombia: Prensa Creativa.
64.
Pineda, D., Galeano, L.M., Jasbon, H., Hoyos, L.M., Rodriguez, J.C., & Quiceno, D.L. (1988). Trastornos neuropsicologicos en la enfermedad de Parkinson. [Neuropsychological disorders in Parkinson's disease]. Acta Medica Colombiana, 13, 13-21.
Rey, A. (1941). L'examen psychologique dans les cas d'encephalopathie traumatique. [Psychological assessment in cases of traumatic encepholopathy] . Archives de Psychologie, 28, 286-340.
67.
Reynolds, C.R., & Kamphaus, R.W. (1992). Behavior assessment system for children. Circle Pines, MN: American Guidance Service.
68.
Riccio, C., Hall, A.J., Morgan, A., Hynd, G.W., Gonzalez, J.J., & Marshall, R.M. (1994). Executive function and Wisconsin Card Sorting Test: Relationship with behavioral rating and cognitive ability. Developmental Neuropsychology, 10, 215-229.
69.
Rosselli, M., & Ardila, A. (1991). Effects of age, education and gender on the Rey-Osterrieth Complex Figure test. The Clinical Neuropsychologist, 5, 370-376.
70.
Rosselli, M., & Ardila, A. (1993). Developmental norms for the Wisconsin Card Sorting Test in 5- to 12-year-old children. The Clinical Neuropsychologist , 2, 145-154.
71.
Sandoval, J., & Echandia, A. (1994). Behavior Assessment System for Children. Journal of School Psychology, 32, 419-425.
72.
Shaywitz, B.A., Shaywitz, S.E., Liberman, A.M., Fletcher, J.M., Shankweiler, D.P., Ducan, J.S., Katz, L., Liberman, A.M., Francis, D.J., Dreyer, L.G., Crain, S., Brady, S., Fowler, A., Kier, L.E., Rosenfield, N.S., Gore, J.C., & Makuch, R.W. (1990). Neurolinguistic and biologic mechanism in dyslexia . In D. D. Duane & D. B. Gray (Eds.), The reading brain (pp. 27-52). Parkton, MD: York Press.
73.
Shaywitz, S.E., Holahan, J.M., Marchione, K.E., Sadler, A.E., & Shaywitz, B.A. (1992). The Yale Children's Inventory: Normative data and their implications for the diagnosis of attention deficit disorder in children. In S. E. Shaywitz, & B. A. Shaywitz (Eds.), Attention Deficit Disorder comes of age: Toward the twenty-first century (pp. 29-67). Austin, TX: PRO- ED.
74.
Shealy, A.H. (1994). Attention deficit hyperactivity disorder: Etiology, diagnosis, and management. Journal of Child and Adolescent Psychiatric Nursing, 7, 24-36.
75.
Shue, K.L., & Douglas, V.I. (1992). Attention deficit hyperactivity disorder and the frontal lobe syndrome. Brain andCognition, 20, 104-124.
76.
Taylor, E.M. (1959). The appraisal of children with cerebral deficits . Cambridge, MA: Harvard University Press.
77.
Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests: Administration, norms, and commentary. New York: Oxford University Press.
78.
Swadesh, M. (1967). El lenguaje y la vida humana [Language and human life]. Mexico City: Fondo de Cultural Económica.
79.
Wechsler, D.A. (1945). A standardized memory scale for clinical use. Journal of Psychology, 19, 87-95.
80.
Wechsler, D. (1974). Wechsler intelligence scale for children-Revised . New York: Psychological Corp.
81.
Wechsler, D.A. (1993). Escala de inteligencia para niños-Revisada (WISC-R) . Madrid, Spain: Tea.
82.
Witt, J.C., Heffer, R.W., & Pfeiffer, J. (1990). Structural rating scales: A review of self-report and informant rating process, procedures, and issues. In C. R. Reynolds & R. Kamphaus (Eds.), Handbook of psychological and educational assessment of children (pp. 364-394). New York: Guilford Press.
